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.nco,TZ'r r-C 111=110TICIr- w Tc nr ■ ■ w It1■■ ■��i .. <br />`� v�■� ■ ■■ ■Vr1 I G Vr LIH�ILI I T IIroJUKANC.:t _^o3/12no12•�/ <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS <br />NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, <br />EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. <br />THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING <br />INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER_ <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed_ If SUBROGATION IS WAIVED, <br />subject to <br />the terns and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to <br />the certificate holder in lieu of such endorsements . <br />PRODUCER <br />GONTgGT <br />CSBS/VAN LEER AMBASSADOR GRP INS SVC <br />PHONE <br />FAX <br />PO BOX 946580 <br />No Ea[ : <br />EMA/G <br />A L <br />Maitland, FL 32794-6580 <br />ADDRESS: <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />1-877-724-2669 <br />Iy <br />NSURERA Pan Continental Casual Company <br />20443 <br />INSURED <br />INSURER B: <br />CARD METER SYSTEMS, INC. 11 SURERC: <br />5325 EAST ELENA AVENUE INSURER 0- <br />MESA, AZ 85206 \ \ - INSURER E: <br />1 1- <br />I\l .20 019 <br />COVERINSURER F:AGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE <br />INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDINGANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INJR <br />LTR <br />IN <br />TYPE OF INSURANCE INew <br />auaut <br />POLICY NUMBER <br />POLICY EFF <br />POLICY EXP <br />D <br />MM/DD(MM10­1 <br />LIMITS <br />A <br />GENERAL <br />LIABILITY <br />Y <br />Y <br />4026961553 <br />05/01/12 <br />05/01/13 <br />EACHOCCURRENCE <br />$ 1,000,000 <br />COMMERCIAL GENERAL LIABILITY <br />PgDAMAG ET � ATE^— <br />S 300QQQ <br />MED EXP (Any one person) <br />S 10,000 <br />CLAIMS -MADE OCCUR <br />PERSONAL 6 ADV INJURY <br />S 1,000,000 <br />GENERAL AGGREGATE <br />S 2,000,000 <br />GEN'L AGGREGATE LIMIT APP�LI/ES PER: <br />PRODUCTS - COMP/OP AGG <br />S 2,000,000 <br />P ICY ECT X LOC <br />A <br />AUTOMOBILE <br />LIABILITY <br />4025961505 <br />05/01/12 <br />05/01/13 <br />C M INED SIN -MIT <br />(Ee ecrJtlant) <br />S <br />ANY AUTO <br />BODILY INJURY(Per person) <br />j <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY(Par ectltlam) <br />S <br />�/ NON -OWNED <br />HIRED AUTOS /\ AU_(Per <br />PROPERTY OAMAGE <br />a Ident) <br />j <br />S <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />i <br />EXCESS <br />CLAIMS -MADE <br />AGGREGATE <br />S <br />DED I RETENTION $ <br />A <br />ON <br />AND EMPLOYERS' uAHILIiTY Y/N <br />4025961410 <br />05/01/12 <br />05/01/13 <br />/\ <br />TORY LIMITS <br />ER <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />E.L. EACH ACCIDENT <br />i 1,000,000 <br />OFFICER/MEMSER EXCLUDED? <br />N/A <br />(Mandatory in NH) <br />$ <br />If yee. describe Under <br />DESCRIPTION <br />APPR <br />VED AS TO <br />i=ORiM <br />E.L. DISEASE - EA EMPLOYEE <br />1,000,000 <br />E.L. DISEASE - POLICY LIMIT <br />$ 1 QQQ 000 <br />OF OPERATIONS below <br />OTHER <br />TORY LIMITS ER <br />i <br />-" '- E.L. EACH ACCIDENT S <br />i <br />A9-LSLdnL CLLy ALLO nCY E.L. DISEASE -EA EMPLOYEE <br />E.L. DISEASE - POLICY LIMIT S <br />D RIP? N FOP RA NS / L A NS / VEHI L (Attacl, Aeor �, AddlUona emarXa cl,edule, moro space is require <br />City of Santa Ana, its officers, agents and employees and representatives is Named as Additional Insured - Designated Person or <br />Organization. Insurance Is primary & non -contributory - <br />City of Santa Ana Parks, Recreation and Community Services <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />Agency <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Attn: Silvia Cuevas 26 Civic Center Plaza <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92701 <br />C)1988-2010 ACORD CORPORATION. All rights reserved. <br />e rnlan �c r�n�ninci rHe e.r-ran ......e �...a I,.,.,, �.,e .e..l�•e.�a,rl ...�.a.a r.s Arnon <br />